Table 2. Targeted Screening for People with Hypertension Only, with Intensive Glycemic Control and Intensified Hypertension Control after Diagnosis

Illustrative Case in the Model Age at Diagnosis, (y) Results per True Diabetes Case Results per Person Screened Cost/
QALY ($)
Lifetime Cumulative Incidence (%) Life-Yearsa QALYsb Lifetime Costs ($)a Life-Years Gaineda QALYs Gainedb
ESRD LEA Blind Stroke CHD Screen & Diagnostic Testing Diab. Treatment Diab. Intervention Diab. Complications Total
Screen at 35 y   (onset at 30 y)
W/o screening 40 25.30 40.18 12.32 13.08 21.86 33.27 19.73 0 1,012 920 2,619 4,551      
W/ screening 35 24.68 40.27 12.41 13.24 21.51 33.45 19.81 25 1,174 1,149 2,569 4,917      
Screening effect   -0.62 0.09 0.09 0.16 -0.35 0.18 0.08 25 162 229 -50 366 0.010 0.004 87,096
Screen at 45 y   (onset at 40 y)
W/o screening 50 14.90 27.64 8.72 15.12 26.13 26.20 16.84 0 830 758 1,827 3,415      
W/ screening 45 14.57 27.92 8.87 15.40 24.67 26.49 17.00 25 999 999 1,798 3,820      
Screening effect   -0.33 0.28 0.15 0.28 -1.46 0.30 0.16 25 169 241 -29 405 0.016 0.008 46,881
Screen at 55 y   (onset at 50 y)
W/o screening 60 6.50 15.10 5.15 15.38 29.93 18.90 13.23 0 941 858 1,884 3,682      
W/ screening 55 6.39 15.40 5.29 15.76 27.40 19.24 13.44 25 1,187 1,221 1,859 4,292      
Screening effect   -0.11 0.3 0.14 0.38 -2.53 0.35 0.22 25 246 363 -25 610 0.029 0.018 34,375
Screen at 65 y   (onset at 60 y)
W/o screening 70 1.82 6.04 2.45 15.58 28.87 12.30 9.34 0 249 223 526 998      
W/ screening 65 1.79 6.20 2.56 16.06 25.57 12.63 9.57 23 336 361 522 1,242      
Screening effect   -0.03 0.16 0.11 0.48 -3.30 0.33 0.23 23 88 138 -4 245 0.011 0.008 31,228
Screen at 75 y   (onset at 70 y)
W/o screening 80 0.23 1.69 0.84 14.97 24.42 7.28 5.93 0 162 136 422 720      
W/ screening 75 0.22 1.72 0.88 15.40 21.09 7.51 6.11 21 238 270 423 952      
Screening effect   -0.01 0.03 0.04 0.43 -3.33 0.23 0.18 21 76 134 1 231 0.009 0.007 32,106

aUndiscounted.
bDiscounted at 3%.

Note: Screening effects are expressed as percentage points. CHD = Coronary heart disease events; Diab. = Diabetes; ESRD = End-stage renal disease; LEA = Lower-extremity amputation; QALY = Quality-adjusted life year.

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